BMJ 1999;318:1418 ( 22 May )

Letters

Prediction of cardiovascular risk

    Program is not suitable for diabetic patients
    Hypothesis of program is flawed
    Authors' reply

Program is not suitable for diabetic patients

The first 150 words of the full text of this article appear below.

EDITOR---Hingorani and Vallance describe a clinic based computer program for the management of cardiovascular risk factors.1 However, the program has limitations for diabetic patients.

This program and previous methods, together with the recent joint British recommendations,2 are based on algorithms derived from the Framingham heart study of 5573 people aged 30-74 years originally screened in 1968. However, only 4% (237 subjects) of this cohort had diabetes, as defined by a random glucose concentration >9 mmol/l or the use of diabetic treatment. Importantly, diabetes was not classified according to type, and the presence of proteinuria or microalbuminuria (important cardiovascular risk factors in diabetes) were not included.

The prevalence and characteristics of other risk factors further highlight that people with diabetes are not average patients3; "diabetic dyslipidaemia," increased prevalence of hypertension, and ethnic origin (for example, south Asian) contribute to an increased atherogenic potential. Despite the strong link between triglyceride concentration and coronary . . . [Full text of this article]
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Relevant Article

A simple computer program for guiding management of cardiovascular risk factors and prescribing
Aroon D Hingorani and Patrick Vallance
BMJ 1999 318: 101-105. [Abstract] [Full Text] [PDF]

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